PHYSICAL AND MENTAL TRAINING. TECHNOLOGICAL INNOVATION AND VIRTUAL REALITY AS AN APPROACH TO NEUROREHABILITATION.
Life expectancy is increasing and the world population is progressively ageing. It is estimated that by 2050 the proportion of the over-80s – in industrialised countries – will quadruple and, for the first time, in the next five years, the number of the over-65s will exceed that of the under-5s(1*) . Chronic degenerative diseases are also on the rise with a foreseeable significant increase in the number of people with disabilities and consequent impacts on socio-economic balances that should not be underestimated (in fact longevity shock is currently a hot topic).(2*)
In this context, the state of health of the elderly should no longer be identified solely with the reduced presence of disease, but with the maintenance of psychophysical and relational well-being. even in the presence of multiple pathologies. The concept of life expectancy goes beyond the mere number of years lived and the primary objective becomes maintaining the self-sufficiency and well-being of the elderly.
Health and healthcare can benefit substantially fromtechnological innovation that offers solutions to improve people’s quality of life. Let’s look at some applications in our area.
Adapted Physical Activity and Cognitive Stimulation: the experience of the Liguria Region
While the population of Europe is the oldest one in the world, Italy is the absolute leader in the over-65s group (22.8%) with the region of Liguria top of the ranking: 28.8% in the province of Genoa and 40% in the hinterland(3*) .
As early as 2008, ASL 4 Liguria (Chiavari) launched the first Adapted Physical Activity(AFA) course, to prevent certain chronic diseases and counteract the worsening of existing ones.(4* ) In 2013, the Liguria Region, when recognising its best practices, resolved to extend AFA to the regional level, also associating cognitive stimulation courses (Memory Training – MT)(5*) .
More than 80,000 sessions, with courses geared towards primary, secondary and tertiary prevention of many chronic diseases typical of ageing, significant improvements in the participants’ state of well-being and daily life skills, and considerable savings for the health sector due to a reduction in specialist services, instrumental examinations and drug consumption: these are results of the project that prove its effectiveness. They also leave more and more room for social involvement and active ageing techniques through the use of information technology and telemedicine as the main drivers for the digital future of health(6* ), including virtual reality.
VR: a new approach to the patient
The effectiveness of VR is firstly explained by the fact that it shares the same basic mechanism as the brain, i.e. embodied simulations (ES).
According to recent findings in neuroscience, in order to effectively regulate and control one’s body in its environment, the brain creates an ES to represent and predict actions, concepts and emotions. Virtual reality works in a similar way: the VR experience attempts to predict the sensory consequences of an individual’s movements by providing them with the same scene they will see in the real world.
If VR is an embodied technology, this indicates a new clinical approach to the patient, namely the possibility of guiding the experience of the body and facilitating its cognitive change.
Clinical potential of VR: neuromotor rehabilitation
A recent analysis (7*) shows precisely the potential of this technology in the diagnosis and treatment of various disorders, both behavioural and physical, also with long-term effects. VR facilitates neurorehabilitation by promoting the brain plasticity processes through complex mechanisms related to the reactivation of the brain neurotransmitter capacities. From a motor point of view, VR is a useful tool to improve locomotion through its ability to provide personalised feedback on performance and simulate real-world challenges. In conclusion, the possibility of experimenting VR technology in a controlled environment and on numerous subjects that have been known and monitored for years allows for the detection of unique and peculiar characteristics that can help identify innovative and repeatable best practices on a large scale with positive effects and both social and economic developments